Online GP appointments found to be largely ineffective

There is a general push in the UK to find new digital means of reducing the workload on doctors and on GPs, as the NHS faces increased strain due to an ageing population and reduced funding.

One idea offered was to push online GP consultations that would allow patients to input symptoms to be checked by GPs to determine whether patients needed a further appointment. The idea being that GPs could effectively sift through patients most at need, whilst being able to offer simple advice to someone not requiring immediate medical intervention.

In theory, it sounded great and NHS England is currently offering a £45 million fund to support GP practices adopting such technology. However, a report published in the BMJ found that a system (eConsult) piloted across 36 GP practices in Bristol, North Somerset and South Gloucestershire saw very little uptake and most people who used the service ended up having a telephone or physical consultation regardless.

In total, only two e-consultations occurred each month per 1,000 patients, with usage coinciding to the busiest times that GP practices usually face (Monday to Wednesday). Only 12% of users consulting the system used it on weekends, when it could, theoretically, be most helpful to reduce workload.

Clinicians using the system reported that the system worked best for simple and routine enquiries, while 38% of e-consultations ended up resulting in a face-to-face consultations and a further 32% in a telephone conversation.

Dr Jeremy Horwood, of NIHR CLAHRC West and University of Bristol's Centre for Academic Primary Care, said: "While our study focused on a particular system in a regional GP consortium, there are lessons here for any GP practice considering moving to an electronic consultation system. There is a central government drive to move to these systems. However, our research shows that they need to be carefully implemented and effectively marketed to yield the benefits that politicians are hoping for. Online consultations may have value for some patients, such as straightforward medical enquiries, but they cannot replace face-to-face consultations in situations which are more complex."

The study reveals that there is still a long way to go before technology is able to provide a more viable adjunct to traditional forms of consultation, though eConsult revealed that it now provides support to 350 practices across the country.